Application of Portable Ultrasound Scanners in the Measurement of Post-Void Residual Urine

Abstract

The aims of the present study were to investigate the impact of research subjects' characteristics on the accuracy of the BladderScan when the latter is used to measure post-void residual urine volume, and to evaluate differences between BladderScan and catheterization in terms of the expenditure of time and of human and material resources. Subjects in the present study were 71 patients undergoing inpatient or outpatient rehabilitation therapy. Post-void residual urine was measured with the BladderScan BVI 3000, followed by intermittent catheterization. Repeated-measures ANOVA revealed no statistically significant difference between the post-void residual urine volume measured by the bladder ultrasound and that of catheterization, or among the factors: sex, diagnosis, body position, thickness of abdominal fat, bladder shape, urine volume, and time intervals between operations. The BladderScan averaged 45 seconds (range = 17 -119 seconds), while catheterization averaged 293 seconds (range = 136 -664 seconds); the time required for catheterization was 3 to 8 times that for the BladderScan. The BladderScan gave accurate measurements of post-void residual urine volume for all of the subjects. Using the BladderScan first to measure post-void residual urine volume can reduce the frequency of catheterization, and can save medical human resources costs as well.

Systematic bladder scanning identifies more women with postpartum urinary retention than diagnosis by clinical signs and symptoms

“…Differences between bladder scanning and catheterization could be due to technical problems. The uterine shape and size or blood in the uterus may be mistaken for urine in the bladder (Teng et al, 2005;Altschuler and Diaz, 2006;Saint et al, 2009). Although, bladder scanning is considered to be a reliable method for assessing PVRBV in women who recently delivered, the estimated volume may differ between bladder scanning and catheterization (Van Os and Van der Linden, 2006;Lukasse et al, 2007).…”

“…Catheterization is an accurate diagnostic and therapeutic method, but can lead to infection (Yip et al, 2004). Ultrasound scanning is non-invasive but ultrasound measurements may be inaccurate in women who recently delivered (Teng et al, 2005;Altschuler and Diaz, 2006;Saint et al, 2009). The use of a bladder scan routine for identification of PUR is debatable (Mulder et al, 2014;Buchanan and Beckmann, 2014).…”

The accuracy of post-void residual measurement in women

“…To avoid an overestimation of the PVR, it is best to minimize any diuresis factor. Clinically, especially in the urodynamic laboratory, the delay should be minimized between voiding and PVR measurement: ultrasonic techniques can measure PVRs within 60 s of voiding [9,10]; PVR measurement by urethral catheterization can be achieved efficiently within 5 min of voiding [8,10] or inefficiently up to 10-16 min [10]. In the hospital postoperative situation, effective drainage of suprapubic catheters can occur within 5 min [11].…”

“…Ultrasound techniques of known accuracy offer the best prospects of achieving these aims, cost considerations allowing. There are, of course, known benefits to patients [10] of reduced psychological stress and possible physical problems (urinary tract infections, urethral trauma, and hematuria). The benefits of ultrasound for PVR measurement (known accuracy, reduced time and patient trauma) need to be added to the increasing array of other indications for ultrasound in urogynecology (bladder neck assessment and intercurrent lower urinary tract and pelvic floor pathology, etc.…”

ISC in women following urogynaecologic surgery

“…If urine output is less than 2mls/kg over 4 hours or 0.5mls/kg/hr the doctor should be notified as this may indicate voiding dysfunction (NICE, 2007 andScales andPilsworth, 2008). Although abdominal examination/palpation can detect a significantly enlarged bladder of 300mls or more (Hilton and Stanton, 1981), the use of a portable ultrasound bladder scanner is considered a more accurate, reliable and less invasive method of accurately determining residual volumes and should be used in preference to catheterisation where available (NICE, 2013 andTeng, 2005). …”